ENT
Ear Wax (Impacted Cerumen)
Ear blockage, itching or earache with wax in the ear canal. Soften with ear drops, then suction after 4 days.
- ICD-10
- —
- Source
- OPD handbook pp.118–119
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
- Ear blockage (2 weeks in the samples)
- Itching
- Earache
Diagnosis
- Wax in both ears (hard black wax in the second sample)
Treatment
Step 1 of 3
1. Soften the wax
- Sodaglycerin ear drops 4 drops four times a day for 4 days
- Antihistamine at night if itching
- Follow up after 4 days for suctioning
Prescription
Sodium bicarbonate + Glycerin ear drops (wax softener)Ceruminolytic ear drops
Dose4 drops, 4 times a day
Brand Sodaglycerin ear drops
4 days
CetirizineAntihistamine
Dose1 at night (itching)
Brand Tab Sedil 10 mg / Rigix 10 mg
Also sold as Rigix, Sedil, Antial, Neo-Antial, Cetrix, Zyrtec
Step 2 of 3
2. After suctioning with the sucker machine
- Cipocaine ear drops 3+3+3
- Painkiller if pain: Tab Voren 50 mg or Dicloran 50 mg 1+1
Prescription
Ciprofloxacin + Lignocaine (xylocaine) ear dropsTopical antibiotic + local anaesthetic
Dose3+3+3 drops
Brand Cipocaine ear drops
3–5 days (sample)
Diclofenac sodiumNSAID
Dose1+1 if pain
Brand Tab Voren 50 mg / Dicloran 50 mg
Also sold as Voren, Diclo, Dicloran
CetirizineAntihistamine
DoseAt night
Brand Tab Sedil 10 mg
5 days (sample)
Also sold as Rigix, Sedil, Antial, Neo-Antial, Cetrix, Zyrtec
Step 3 of 3
3. Counselling (Urdu notes)
- Do not put match-sticks in the ear
- Keep the ear dry
- Apply oil on cotton while bathing and place it in the ear